The stress distribution of a primary molar tooth restored with stainless steel crown using different luting cements.

BACKGROUND: The aim of this study is to evaluate the stress distributions of a primary molar tooth restored with a stainless steel crown (SSC) using resin and glass ionomer luting cements by Finite Element Analysis (FEA). METHODS: Original DICOM data of a primary molar was used to create a 3D model. One model was prepared as a tooth model with SSC. A 30 µm cement layer was used in model. Two different luting cements were tested in the study: self-cure adhesive resin cement, and glass ionomer cement. Vertical and oblique loads of 330 N were applied to simulate maximum bite force and lateral forces in the occlusal contact areas of the models. Maximum von Mises stress values in the models were evaluated as MPa. RESULTS: The maximum von Mises stress value was observed in the force application and general occlusal contact areas for all models. The maximum von Mises stress values were higher in the tooth model with SSC using self-cure adhesive resin cement (478.09 MPa and 214.62 MPa) than in the tooth model with SSC using glass ionomer cement (220.06 MPa and 198.72 MPa) in both vertical and oblique loading, respectively. CONCLUSIONS: Depending on the magnitude of the bite force on the SSC, fracture of the luting cement materials could occur if the stress exceeds the endurance limit of the luting cement. Cementation with glass ionomer cement may help to reduce stress levels in SSC restorations of primary molars in children.

Randomized clinical trial of pulpotomy using a premixed injectable calcium silicate cement on mature permanent teeth with reversible pulpitis.

The aim of this two-center randomized controlled trial was to assess the outcomes and relative factors associated with pulpotomies performed using a premixed injectable calcium silicate cement, as compared to mineral trioxide aggregate in mature permanent premolar and molar teeth with reversible pulpitis. Included teeth were randomly divided into two groups according to pulpotomy material (ProRoot MTA [PMTA] group, Endocem MTA Premixed [EPM] group). After pulp exposure, the superficial pulp was either removed to a depth of 2 mm (partial pulpotomy) or completely amputated to the level of the root canal orifice (full pulpotomy). A 3-mm layer of either material was randomly placed over the pulp wound, followed by the application of a thin layer of a light-cured glass ionomer composite liner. The restoration procedure was then carried out during the same visit. After one year of treatment, the pulpotomy success rate was 94.4% (67/71), with no significant difference between the PMTA and EPM groups. The success rate was 93.9% in the PMTA group and 97.1% in the EPM group. There were no significant factors related to the procedures. EPM is a viable alternative to PMTA for single-visit pulpotomies of permanent premolars and molars.

Clinical Performance of Glass Ionomer Cement in Load-Bearing Restorations: A Systematic Review.

Glass ionomer cement (GIC) is a self-adhesive dental restorative material composed of a polyacrylic acid liquid and fluoro-aluminosilicate glass powder. It is commonly used for cementation during dental restoration. This study aimed to systematically review the existing literature regarding the clinical performance of GIC in load-bearing dental restorations. A comprehensive literature search was conducted in EBSCO, PubMed, Embrace, and Cochrane databases. Only randomized controlled trials (RCTs) were included in the search, and a broad search technique was used, where inclusion and exclusion criteria were applied. After a thorough evaluation, 12 RCTs were extensively reviewed, and whether GIC is suitable for load-bearing restorations was determined. Significant variations in staining surface or margin, color match, translucency, esthetic anatomical form, retention, material fracture, marginal adaptation, surface luster, occlusal contour, wear, and approximal anatomical form indicated the unsuitability of GIC. By contrast, significance differences in patient view and periodontal response indicated that GIC is suitable. No significant differences in postoperative sensitivity, recurrence of caries, or tooth integrity were observed. Nevertheless, the results of the review demonstrated that the clinical performance of GIC is comparable to that of traditional restorative materials with regard to the parameters analyzed. GIC is a suitable restorative material for load-bearing restorations regarding surface margin, esthetic anatomical form, material retention and fracture, marginal adaptation, occlusal contour, wear, and approximal anatomical form. It reduces other parameters, such as postoperative sensitivity, recurrence of caries, and tooth integrity.

Effect of silver diamine fluoride on the microleakage of flowable resin composite and glass ionomer cement restorations to carious primary dentin: an-in vitro study.

BACKGROUND: This study aimed to evaluate the effect of Silver Diamine Fluoride (SDF) on the microleakage of flowable resin composite (FRC) and resin-modified glass ionomer cement (GIC) restorations bound to carious primary dentin. METHODS: Forty-four extracted carious primary molars were allocated into four groups as follows (n = 11 teeth/group): Group I, Flowable resin composite (FRCa): SDF38% treatment + FRC, Group II, Flowable resin composite (FRCb): FRC without SDF treatment, Group III, Resin-modified glass ionomer cement (GICa): SDF38% treatment + GIC, Group IV, Resin-modified glass ionomer cement (GICb): GIC without SDF treatment. Specimens were subjected to thermo cycling at 500 cycles between 5 to 55 °C (dwell time of 60 seconds) in baths before being immersed for 24 h in a 1% toluidine blue solution. Microleakage testing was conducted for each specimen in two areas; occlusal and gingival. Specimens were evaluated under stereomicroscope at 4x magnification. Results were analyzed using Kruskal-Wallis test followed by pairwise comparisons utilizing Dunn's post hoc test at p ≤ 0.05. RESULTS: Insignificant differences between different groups (p = 0.49) were observed at the gingival walls area readings. The highest value was found in GICb (2.33 ± 0.52), while the lowest value was found in FRCa (1.71 ± 0.76). Insignificant differences between different groups (p = 0.982) were observed at the occlusal walls area readings. The highest value was found in FRCa (1.43 ± 0.98), while the lowest value was found in GICb (1.17 ± 1.33). CONCLUSION: SDF does not adversely affect the microleakage of FRC and GIC restorations bound to carious primary dentin.

Shear bond strength of calcium silicate-based cements to glass ionomers.

BACKGROUND: A shear bond strength between the biomaterial and restorative material is crucial for minimizing bacterial microleakage and ensuring a favorable long-term prognosis for vital pulp therapy. This study aimed to conduct a comparative evaluation of the shear bond strength between calcium silicate-based biomaterials utilized in vital pulp treatment and various glass ionomer cement materials, both with and without the application of adhesive agents. METHODS: A total of 270 acrylic blocks, each featuring cavities measuring 4 mm in diameter and 2 mm in depth, were prepared. Calcium silicate-containing biomaterials (ProRoot MTA, Medcem Pure Portland Cement, and Medcem MTA), following manufacturers' instructions, were placed within the voids in the acrylic blocks and allowed to set for the recommended durations. The biomaterial samples were randomly categorized into three groups based on the restorative material to be applied: conventional glass ionomer cement, resin-modified glass ionomer cement, and bioactive restorative material. Using cylindrical molds with a diameter of 3.2 mm and a height of 3 mm, restorative materials were applied to the biomaterials in two different methods, contingent on whether adhesive was administered. After all samples were incubated in an oven at 37 °C for 24 h, shear bond strength values were measured utilizing a universal testing device. The obtained data were statistically evaluated using ANOVA and post-hoc Tukey tests. RESULTS: The highest shear bond strength value was noted in the Medcem MTA + ACTIVA bioactive restorative material group with adhesive application, while the lowest shear bond strength value was observed in the ProRoot MTA White + Equia Forte HT Fil group without adhesive application (P < 0.05). CONCLUSION: Activa Bioactive Restorative may be considered a suitable restorative material in combination with calcium silicate-based biomaterials for vital pulp treatment. The application of adhesives to calcium silicate-based biomaterials can effectively address the technical limitations.

Clinical performance of a glass-hybrid system in comparison with a resin composite in two-surface class II restorations: a 5-year randomised multi-centre study.

OBJECTIVE: To evaluate the 5-year clinical performance of a glass hybrid restorative system and a nano-hybrid resin composite in moderate to large two-surface class II cavities. MATERIALS AND METHODS: This study was carried out by dental schools in Zagreb, Croatia; Izmir, Turkey; Belgrade, Serbia; and Milan, Italy. A total of 180 patients requiring two class-II two-surface restorations in the molars of the same jaw were recruited. The teeth were randomly restored with either a nano-hybrid resin composite (Tetric EvoCeram, Ivoclar Vivadent) or a glass-hybrid material (EQUIA Forte, GC). During the 5-year follow-up, two calibrated evaluators at each centre scored the restorations annually using the FDI-2 scoring system. The survival rates were calculated using the Kaplan-Meier method and compared using non-parametric matched pair tests (p < 0.05). RESULTS: There were no statistically significant differences between the overall survival and success rates of the two types of restorations (p>0.05). The success rates (FDI-2 scores 1-3) for EQUIA Forte were 81.9% (average annual failure rate: 3.9%) and 90.7% for Tetric EvoCeram (average annual failure rate: 1.9%). The survival rates (FDI-2 scores 1-4) for EQUIA Forte and Tetric EvoCeram were 94.5% and 94.4%, respectively, with an average annual failure rate of 1.1%. CONCLUSIONS: In terms of success and survival rates, both the glass-hybrid restorative system and the nano-hybrid resin composite have been shown to perform satisfactorily. CLINICAL RELEVANCE: The results of this study indicate that EQUIA Forte can be one of the therapeutic options for moderate to large two-surface class II restorations of posterior teeth.

Randomised clinical trial of Class II ART restoration in primary teeth with and without retentive grooves after 12 months.

AIM: The aim of the study was to evaluate the survival of Class II ART (Atraumatic Restorative Treatment) restorations in primary molars using encapsulated glass ionomer in cavities with and without retentive grooves. A total of 293 Class II restorations were performed on primary molars by three trained operators, using ART hand instruments (SS White/Duflex, Rio de Janeiro, Brazil) and restored with EQUIA Fil (GC Corporation, Tokyo, Japan). One hundred eighty-seven children aged 3 to 7 years (mean age = 5.5) from two public schools located in Lima, Peru, were included in the study. The restorations were performed following the ART protocol, randomising the presence or absence of proximal retentions. Cavity cleaning and restoration times were recorded by the assistant using a digital chronometer. After 6 and 12 months, evaluations occurred following the ART criteria. Data were analysed using the Mann-Whitney, Chisquare and Fisher's exact tests, Kaplan-Meier survival and logarithmic range. The mean dmf-s of the participants was 21.6 (S.D. = 10.2). The mean times to clean the cavity and apply the restorative material were 5.4 and 6.6 minutes, respectively. Success rates after 6 and 12 months for restorations without retentive grooves were 90.3% and 77.2%, respectively; and with retentive grooves 95.9% and 91.8%, respectively. Statistically significant differences were found at the 12-month follow-up (p = 0.001). The proximal retentive grooves increased the survival rate of ART Class II restorations in primary teeth after 12 months of follow-up.

Evaluation of Fracture Strength after Repair of Cervical External Resorption Cavities with Different Materials.

INTRODUCTION: The aim was to evaluate the stress distributions on dentin and repair materials caused by static force applied to teeth, with cervical external root resorption (CER) after repair with different materials using finite element analysis. METHODS: This study was performed with the 3-dimensional finite element analysis method. Access cavity, root canal cavity dimensions, and supporting tissues other than cementum were modeled in the maxillary central tooth. The CER cavity was created on the labial side of the tooth model. The coronal side of the resorption cavity was restored with composite, and the radicular side with different materials (MTA, Biodentine, BioAggregate, calcium-enriched cement [CEM], glass ionomer cement [GIC], and resin-modified glass ionomer cement [RMGIC]). A static force of 300 N was applied to the palatal surface of the crown at an angle of 135° to the long axis of the tooth. The stress distributions in dentin and repair materials were analyzed. RESULTS: The highest stress in dentin was seen in the fFigmodel with unrepaired CER. In the models repaired with MTA, GIC, and RMGIC, von Mises stress values in dentin were greater than for repairs with Biodentine, BioAggregate, and CEM materials. The von Mises stress on the repair materials applied to the root were highest for the BioAggregate material. This was followed by CEM, Biodentine, MTA, RMGIC, and GIC materials, respectively. CONCLUSION: The repair of CER in the tooth significantly decreased the stress values in dentin. Biodentine, BioAggregate, and CEM absorbed more force and caused less stress to be transmitted to dentin compared to MTA, GIC, and RMGIC.

Do bioactive materials show greater retention rates in restoring permanent teeth than non-bioactive materials? A systematic review and network meta-analysis of randomized controlled trials.

OBJECTIVES: To answer the following research question: does the clinical evaluation of restorations on permanent teeth with bioactive materials show greater retention rates than those with non-bioactive materials? MATERIALS AND METHODS: A search strategy was used in the following databases: MEDLINE via PubMed, Scopus, Web of Science, LILACS, BBO, Embase, The Cochrane Library, and OpenGrey. Randomized controlled trials (RCTs), with a minimum of 2-year follow-up and evaluating at least one bioactive material in permanent teeth were included. Risk of bias was detected according to the Cochrane Collaboration tool for assessing the risk of bias (RoB 2.0), and network meta-analysis was performed using a random-effects Bayesian-mixed treatment comparison model. RESULTS: Twenty-seven studies were included. The success of the restorations was assessed using modified USPHS system in 24 studies and the FDI criteria in 3 studies. Network meta-analysis revealed three networks based on restoration preparations. Resin composites were ranked with higher SUCRA values, indicating a greater likelihood of being the preferred treatment for class I, II, and III restorations. In class V, resin-modified glass ionomer cement was ranked with the highest value. CONCLUSION: Bioactive restorative materials showed similar good clinical performance in terms of retention similarly to conventional resin composites. CLINICAL SIGNIFICANCE: The findings must be interpreted with caution because many RCT on restorative materials aim to verify the equivalence of new materials over the gold standard material rather than their superiority. The present systematic review also suggests that new RCT with longer follow-up periods are necessary.

Influence of inorganic nanoparticles on dental materials' mechanical properties. A narrative review.

Inorganic nanoparticles have been widely incorporated in conventional dental materials to help in improving their properties. The literature has shown that incorporating nanoparticles in dental materials in different specialties could have a positive effect on reinforcing the mechanical properties of those materials; however, there was no consensus on the effectiveness of using nanoparticles in enhancing the mechanical properties of dental materials, due to the variety of the properties of nanoparticles itself and their effect on the mechanical properties. This article attempted to analytically review all the studies that assessed the effect of different types of inorganic nanoparticles on the most commonly used dental materials in dental specialties such as polymethyl methacrylate, glass ionomer cement, resin composite, resin adhesive, orthodontic adhesive, and endodontic sealer. The results had shown that those inorganic nanoparticles demonstrated positive potential in improving those mechanical properties in most of the dental materials studied. That potential was attributed to the ultra-small sizes and unique physical and chemical qualities that those inorganic nanoparticles possess, together with the significant surface area to volume ratio. It was concluded from this comprehensive analysis that while a definitive recommendation cannot be provided due to the variety of nanoparticle types, shapes, and incorporated dental material, the consensus suggests using nanoparticles in low concentrations less than 1% by weight along with a silane coupling agent to minimize agglomeration issues and benefit from their properties.

Silver diamine fluoride modified atraumatic restorative treatment compared to conventional restorative technique on carious primary molars-A randomized controlled trial.

OBJECTIVE: To compare the success of silver diamine fluoride-modified atraumatic restorative technique (SMART) with that of the conventional drill and fill method in restoring carious lesions in primary molars. METHOD: Children (4-8years old) reporting to a tertiary care hospital setting with asymptomatic cavitated dentinal carious lesions in primary molars were randomly allocated to two groups; SMART and Conventional; and subsequently restored with Glass Ionomer Cement (GIC). Follow-up evaluations were carried out by blinded independent evaluator at 6-months intervals to assess the status of restorations. Primary outcome was the success of restorations at 24 months and the secondary outcome was the child's behaviour and acceptance of the treatment at the time of interventions. Two sample Z-test of proportion, logistic regression analysis and Chi-square test were used to compare the outcomes in two groups. RESULTS: A total of 226 children (SMART group, 112 and conventional, 114) were included with 280 and 282 GIC restorations placed by the SMART and the conventional method respectively. At 24-months, 459 (81.6 %) primary molars were available for evaluation. Success rates of restorations was 38.4 % and 45.8 % % in SMART and conventional groups respectively (p = 0.105). The rate of acceptability of treatment in the SMART and conventional group was 79 % and 56 % (p<0.001) respectively. CONCLUSION: There was no significant difference in the success rates of GIC restorations by SMART and conventional technique in carious primary molars at 24 months. SMART was better accepted by children as compared to the conventional restorative technique. CLINICAL SIGNIFICANCE: SMART can be an alternative option to treat the asymptomatic carious lesions in primary molars and is well accepted by children than the conventional drill and fill technique thus implying that it has a useful role in un-cooperative children.

Compomers for the restorative treatment of dental caries in primary teeth: An umbrella review.

OBJECTIVES: This umbrella review comprehensively appraised the evidence on the use of compomers in comparison to other dental filling materials for restorative treatment of decayed primary teeth. DATA: The literature search was conducted based on the question: "Is the use of compomers as a dental filling material more successful in the restorative treatment of decayed primary teeth than other dental filling materials?" No language restriction was applied and systematic reviews published up to May 2023 were included. The ROBIS tool was used to assess the methodological quality of the included systematic reviews. Data were extracted for narrative synthesis, considering the restoration failure/success outcomes. SEARCH: Online search was conducted in three databases (PubMed/Medline, Embase and Cochrane library). STUDY SELECTION: The electronic search yielded a total of 779 publications. Finally, 18 systematic reviews were included in this umbrella review. Four systematic reviews presented a low risk of bias, 11 presented an unclear risk of bias and three presented a high risk of bias. Most systematic reviews presenting low risk of bias reported no difference in the success rates of compomers compared to other dental filling materials used for restoration of decayed primary teeth. Studies that found a significant difference or that made clear recommendations towards the use of compomers were commonly rated with a high risk of bias. CONCLUSION: Compomers are similar to other dental filling materials for the placement of direct restorations in primary teeth. CLINICAL SIGNIFICANCE: The results of this umbrella review indicate a similar clinical performance of compomers compared to other materials containing a resin component for direct restoration in primary teeth. Therefore, the choice of restorative material will depend on multiple factors, such as clinician's skills/preferences, patients' wishes, costs, and cavity type/location.

Fracture resistance of primary molars after pulpotomy procedure using mineral trioxide aggregate or Biodentine.

In this study, the effect of mineral trioxide aggregate (MTA) and Biodentine on the resistance to fracture of pulpotomized primary molars was evaluated. 75 primary molars were divided into 2 control groups (positive and negative) and 3 experimental groups with 15 teeth each. No treatment was applied to the teeth in the negative control group. In the teeth in the positive control group, pulpotomy cavities were performed, but not filled. In the teeth in the experimental group, pulpotomy cavities were performed, and filled as follows. Group 3: mineral trioxide aggregate + glass ionomer cement (GIC); Group 4: Biodentine + GIC and Group 5: zinc oxide-eugenol + GIC. Final restorations in teeth in all experimental groups were completed with composite filling material. 75 teeth were then subjected to fracture resistance testing. Obtained data were analyzed statistically. Sorting by fracture resistance; Group1 > Group 4 > Group 3 = Group 5 > Group 2 (p < 0.05). Restorable fracture type was predominant in experimental groups (p < 0.05). The use of Biodentine in teeth undergoing pulpotomy in primary teeth can be preferred as a suitable base material to increase resistance to fracture.

Bonding performance of glass ionomer cement to carious dentin treated with different surface treatment protocols using silver diamine fluoride.

This study investigated the influence of silver diamine fluoride (SDF) on the shear bond strength (SBS) to artificial carious dentin and GIC restorations with various SDF application protocols. Artificial caries were prepared on human dentin discs using bacteria model. These samples were randomly allocated to five groups (n = 10/group) according to the following treatment: (1) control group (CD): no treatment (2) CSR: dentin conditioner, SDF, and rinsing (3) CS: dentin conditioner and SDF (4) SRC: SDF, rinsing and dentin conditioner, and (5) SC: SDF and dentin conditioner. The treated-dentin surface was bonded with GIC and subjected to SBS test. Mean SBS was analyzed using one-way ANOVA. Surface morphology and elemental contents after surface treatment were examined (n = 3/group) by scanning electron microscopy with energy-dispersive X-ray spectroscopy (SEM/EDX). There was no significant difference in the mean SBS among CD (2.45 ± 0.99 MPa), CSR (1.76 ± 0.65 MPa), and SRC (2.64 ± 0.95 MPa). Meanwhile, the mean SBS of CS (0.35 ± 0.21 MPa) was significantly lower than the control and SRC group. SEM/EDX demonstrated deeper silver penetration in CSR and CS groups when compared to SRC and SC groups. SDF-modified GIC restorations resulted in significantly lower bond strength in CS and SC groups. The findings suggested treating the carious dentin surface with CSR and SRC protocol. SDF-treated carious dentin should be rinsed off prior to restore with GIC.

High-viscosity glass-ionomer cement or composite resin for restorations in posterior permanent teeth? A systematic review and meta-analyses.

OBJECTIVES: Answer the PICO question: Do class I and II posterior restorations in permanent teeth placed with high-viscosity glass-ionomer cement (HV-GIC) fail more than composite resin (CR) restorations? DATA: The study was registered in the PROSPERO database (CRD42020138290). Randomized and controlled clinical trials, comparing the performance of HV-GIC and CR in load bearing cavities of posterior permanent teeth were included. Cochrane risk of bias tool and GRADE were used to assess the quality and certainty of the evidence. Meta-analyses were performed for clinical outcomes on USPHS and FDI criteria for 12-, 24- and 36-months follow-ups. SOURCES: PubMed, Scopus and Web of Science were last searched on April 2, 2022, without language or date restrictions. Reference lists of primary studies and their related article link in PubMed were manually searched. STUDY SELECTION: Ten studies were included, while data from 8 were used for the meta-analyses. A total of 849 HV-GIC and 800 CR restorations were followed. The primary outcome was the fracture/retention of the restoration, with a comparable performance for both materials on all follow-ups. The 36 months follow-up for class I restorations (longest) showed risk difference of -0,00 (95%CI -0,03 to 0,03; p = 0,98) and no heterogeneity (p = 0,98, I2=0%). The certainty of the evidence is moderate, as all included studies were at an uncertain risk of bias. CONCLUSIONS: HV-GIC and CR presented comparable clinical performance in posterior permanent teeth up to 36 months. HV-GIV wear in class I restorations followed by 24 months was the only poorer result compared to CR. CLINICAL SIGNIFICANCE: Conservative load bearing cavities in permanent posterior teeth can be restored with HV-GIC with comparable clinical performance to CR expected at least up to 3 years. HV-GIC is a valuable direct restorative option for posterior teeth in high caries risk patients, in which CR is frequently associated with failure.

Comparison of fracture resistance of endodontically treated teeth restored with different aesthetic post and core systems under all ceramic restoration luted with two types of cements.

Context: Fracture of endodontically treated teeth is a grave sequela that a clinician should seriously ponder. Suitable selection of restorative materials is a requisite for long-term clinical success. Aims: To compare the fracture resistance of endodontically treated teeth restored with three different posts luted using two different cements under all ceramic crowns. Settings and Design: This in vitro study was conducted in the Department of Prosthodontics, Government Dental College, Kottayam, Kerala, India. Methods and Material: Thirty endodontically treated single-rooted mandibular premolars in which post spaces were prepared and divided into three different groups. Group 1 (n = 10): zirconia post group. Group 2 (n = 10): quartz fibre post group. Group 3 (n = 10): glass fibre post group. Each group is sub-divided into two based on the luting system: resin-modified glass ionomer cement (RMGIC) or dual-cure resin cement (DCRC). The fracture resistance testing was performed in a universal testing machine with a crosshead speed of 0.5 mm/min. Statistical Analysis Used: The mean fracture resistance were analysed using independent sample Student t-test and one-way ANOVA. Results: : Within the zirconia post group, the mean fracture resistance was higher in DCRC sub-group compared to the RMGIC sub-group and the difference was statistically significant (p = 0.017). The difference in fracture resistance between three different post systems was not found to be statistically significant with respect to both the luting systems. Conclusions: It was observed that when zirconia post is used, the mean fracture resistance was higher in dual-cure resin group compared to the resin-modified GIC group.

Clinical efficacy of bioactive restorative materials in controlling secondary caries: a systematic review and network meta-analysis.

BACKGROUND: This systematic review and network meta-analysis aimed to compare the clinical efficacy of bioactive and conventional restorative materials in controlling secondary caries (SC) and to provide a classification of these materials according to their effectiveness. METHODS: A search was performed in Pubmed, Web of Science, Embase, BBO, Lilacs, Cochrane Library, Scopus, IBECS and gray literature. Clinical trials were included, with no language or publication date limitations. Paired and network meta-analyses were performed with random-effects models, comparing treatments of interest and classifying them according to effectiveness in the permanent and deciduous dentition and at 1-year or 2/more years of follow-up. The risk of bias and certainty of evidence were evaluated. RESULTS: Sixty-two studies were included in the qualitative syntheses and 39 in the quantitative ones. In permanent teeth, resin composite (RC) (RR = 2.00; 95%CI = 1.10, 3.64) and amalgam (AAG) (RR = 1.79; 95%CI = 1.04, 3.09) showed a higher risk of SC than Glass Ionomer Cement (GIC). In the deciduous teeth, however, a higher risk of SC was observed with RC than with AAG (RR = 2.46; 95%CI = 1.42, 4.27) and in GIC when compared to Resin-Modified Glass Ionomer Cement (RMGIC = 1.79; 95%CI = 1.04, 3.09). Most randomized clinical trials studies showed low or moderate risk of bias. CONCLUSION: There is a difference between bioactive restorative materials for SC control, with GIC being more effective in the permanent teeth and the RMGIC in the deciduous teeth. Bioactive restorative materials can be adjuvants in the control of SC in patients at high risk for caries.

Evaluation of the clinical impact and In Vitro antibacterial activities of two bioactive restoratives against S. mutans ATCC 25175 in class II carious restorations.

Background: Streptococcus mutans is a Gram-positive opportunistic bacterial pathogen and that causes dental caries and then restorative treatment remains the best clinical practice approach to repair and prevent dental caries. Aims: This study compared the antimicrobial performance of resin modified glass ionomer cement (RM-GIC) and ACTIVA restoratives by evaluating the S. mutans count, pH levels, and plaque index (PI) scores before and on the 7th day of restoration, and then determined the antimicrobial activities against S. mutans ATCC 25175 in both restoratives in vitro. Materials and Methods: Seventy-eight eligible Saudi female participants, with class II carious lesions, were randomly distributed into RM-GIC and ACTIVA restorative groups. We evaluated the S. mutans count by the serial dilution technique and salivary pH by using a portable pH meter. The PI scores were determined by Silness-Löe method and the antibacterial activity by the agar well diffusion method. Statistical analysis of normality distribution was performed with the Kolmogorov-Smirnov and the difference between groups was an analysis by paired t-test. In addition, the independent sample was compared with the independent samples t-test. Results: Both groups reduced the S. mutans count, pH acidity, and PI scores, and this reduction was statistically significant on the 7th day of restoration (P < 0.05), preference for ACTIVA. The in vitro antibacterial activity against S. mutans ATCC 25175 showed a non-significant difference between both bioactive restorative materials (P < 0.05). Conclusion: The novel application of ACTIVA restorative material is a promising option for patients at risk of caries.

Comparison and evaluation of the effect of polymerization of resin-modified glass ionomer cement and dual-cure resin cement on the crystalline structure of dentin using synchrotron X-ray diffraction and its clinical correlation with postoperative sensitivity.

Aim: To compare the effect of polymerization of resin-modified glass ionomer cement and dual-cure resin cement on the crystalline structure and to correlate it clinically with postoperative sensitivity. Settings and Design: The evaluation of crystalline strain in the dentin slabs was done using Synchrotron X-ray diffraction. The post operative sensitivity was measured clinically using Schiff's sensitivity scale. Materials and Methods: A total of 44 extracted and noncarious premolars were collected. Dentin slabs of dimensions 2 mm × 2 mm × 1.5 mm were prepared from the buccal aspect of the extracted teeth. The dentin slabs were then divided into two groups, Group A dual-cured resin cement and Group B resin-modified glass ionomer cement was applied. The dentin slabs first underwent synchrotron X-ray diffraction before and after the application of cement. Forty-two patients who were undergoing complete metal fixed prostheses on vital posterior abutments were selected. In this, 21 vital abutments were included in each group. Tooth preparation and fabrication of complete metal prostheses were done in the conventional manner and cemented using the 2 luting cements in Groups A and B, respectively. Dentinal hypersensitivity was measured using Schiff 's scale, postcementation, after 1 week and 1 month. Statistical Analysis: Independent t-test was done for comparing the two cements in two cements in terms of lattice strain. Mann-Whitney U-test was done for comparing the cements with respect to dentinal hypersensitivity. Spearman's correlation coefficient was used for clinical correlation between dentinal hypersensitivity and crystalline strain. Results: The lattice strain generated in dual cure resin cement was higher than that in resin-modified glass ionomer cement and was statistically significant. Postcementation hypersensitivity was higher in dual-cured resin than resin-modified glass ionomer cement but was not statistically significant in the follow-up visits. Spearman's correlation coefficients did not reveal any significant clinical correlation between lattice strain and dentinal hypersensitivity. Conclusion: Dual cure resin cements generate greater lattice strain as compared to resin modified glass ionomer cements.

Comparison of the marginal microleakage of a bioactive composite resin and traditional dental restorative materials.

The primary objective of this study was to evaluate the marginal microleakage of Activa Kids BioActive-Restorative used with an adhesive bonding agent (AB+) and compare it with the microleakage of a traditional composite resin (CR), a resin-modified glass ionomer cement (RMGIC), and Activa Kids BioActive-Restorative placed without the use of an adhesive bonding agent (AB-). Standard Class I cavities were prepared in 200 extracted, caries-free permanent molars, which were then restored with 1 of the 4 restorative materials (n = 50 each). The restored teeth were thermocycled for 500 cycles, alternating between 5°C and 55°C with a dwell time of 25 seconds; stained with basic fuchsin dye with a soak time of 24 hours; and sectioned buccolingually. Microleakage was assessed independently by 2 evaluators who viewed specimens under a dissecting microscope at ×30 magnification and assigned scores according to a standardized microleakage scale. Because a Spearman correlation test showed a high correlation between the scores assigned by the 2 evaluators, their ratings for each of the 4 test groups were pooled, and a modified Wilcoxon rank sum test (P < 0.05) was used to analyze the microleakage scores. No difference in microleakage was observed between the AB+ and CR groups (P = 0.8652). Statistically significant differences in microleakage were observed between the AB+ and RMGIC groups (P < 0.0001) as well as between the AB+ and AB- groups (P = 0.0324). The results showed that AB+ had a mean microleakage rate comparable to that of traditional CR. Moreover, AB+ exhibited a lower mean microleakage rate than RMGIC; both the bioactive composite resin and RMGIC are fluoride-releasing materials, so clinicians should consider using AB+, especially in high-caries-risk patients, who are vulnerable to recurrent caries resulting from microleakage and benefit from fluoride release. In this study, AB+ exhibited a significantly lower mean microleakage rate than AB-; therefore, this bioactive material should be used with a bonding agent.